Revisiting Air Travel

     In recent years, we have devoted a considerable number of pages in EMS Magazine to the subject of ambulance safety. Several feature articles have addressed this issue and asked how agencies can improve the safety of providers and patients in emergency vehicles through education and training, protocol changes and technological innovations. Along with the issue of vehicle safety, we have also featured articles that focus on all aspects of safety in the prehospital environment: personal protective equipment, scene safety and highway safety to name just a few. This issue's cover report broaches another safety-related subject that is currently being hotly debated across the industry, that of air medical safety.

     In Sky Anxiety on page 38, Associate Editor John Erich poses the question of how helicopter EMS resources can be deployed more safely following a spate of fatal crashes over the last year that have claimed the lives of 31 people. According to Tom Judge, executive director of LifeFlight of Maine and past president of the Association of Air Medical Services, there needs to be more medical oversight to make sure that the right decisions are being made about which patients need to be transported by air in terms of risk, benefit and cost. How to achieve that is currently being addressed by agencies nationwide. In Maryland, where a Maryland State Police medevac crashed in late September, killing four people, EMS crews are now required to consult with medical control before transporting certain trauma patients to trauma centers by air as opposed to by ground. Maryland had recently revisited field decisions regarding transport to trauma centers as part of the state's new Trauma Tree Decision protocol, designed to both reduce the undertriage of geriatric patients, as well as optimize approprite utilization of transport options.

     "We have to look at it as we would anything in the hospital: Does this patient really need this?" says Judge in Erich's article. Hopefully the dialogue has begun and agencies will begin to address such questions in an effort to prevent more devastating crashes. We welcome your opinions on this topic. E-mail nancy.perry@cygnusb2b.com.